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General NPI Number Information
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NPI Number | 1265628143
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Entity Type | Organization
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Legal Business Name | EXCEL ENT CLINICS, ASSOCIATED
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Dates
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Enumeration Date | 09/24/2007
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 107 TEJAS DR
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City | TERRELL
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State | TX
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Zip | 75160-6567
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Country | US
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Telephone | 972-524-3323
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Fax | 972-524-0929
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Provider Business Mailing Address
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Address Line | 107 TEJAS DR
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City | TERRELL
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State | TX
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Zip | 75160-6567
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Country | US
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Telephone | 972-524-3323
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Fax | 972-524-0929
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER HIMMELHEBER
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Credential | M.D.
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Telephone | 972-524-3323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | K0062
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License Number State | TX
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